A randomized clinical trial of adjuvant chemotherapy for radically resected locoregional relapse of breast cancer: IBCSG 27-02, BIG 1-02, and NSABP B-37

In this phase III, multinational, randomized trial, the International Breast Cancer Study Group, Breast International Group, and the National Surgical Adjuvant Breast and Bowel Project will attempt to define the effectiveness of cytotoxic therapy for patients with locoregional recurrence of breast cancer. We will evaluate whether chemotherapy prolongs disease-free survival and, secondarily, whether its use improves overall survival and systemic disease-free survival. Quality of life measurements will be monitored during the first 12 months of the study. Women who have had a previous diagnosis of invasive breast cancer treated by mastectomy or breast-conserving surgery and who have undergone complete surgical excision of all macroscopic disease but who subsequently develop isolated local and/or regional ipsilateral invasive recurrence are eligible. Patients are randomized to observation/no adjuvant chemotherapy or to adjuvant chemotherapy; all suitable patients receive radiation, hormonal, and trastuzumab therapy. Radiation therapy is recommended for patients who have not received previous adjuvant radiation therapy but is required for those with microscopically positive margins. The radiation field must encompass the tumor bed plus a surrounding margin to a dose of >or= 40 Gy. Radiation therapy will be administered before, during, or after chemotherapy. All women with estrogen receptor-positive and/or progesterone receptor-positive recurrence must receive hormonal therapy, with the agent and duration to be determined by the patient's investigator. Adjuvant trastuzumab therapy is permitted for those with HER2- positive tumors, provided that intent to treat is declared before randomization. Although multidrug regimens are preferred, the agents, doses, and use of supportive therapy are at the discretion of the investigator.

STATIC AND DYNAMIC STRESS CHANGE AT 27 VOLCANOES OF THE CENTRAL AMERICAN VOLCANIC ARC AFTER THE MW. 7.6 COSTA RICA EARTHQUAKE OF 5 SEPTEMBER 2012

Large earthquakes may strongly influence the activity of volcanoes through static and dynamic processes. In this study, we quantify the static and dynamic stress change on 27 volcanoes in Central America, after the Mw 7.6 Costa Rica earthquake of 5 September 2012. Following this event, 8 volcanoes showed signs of activity. We calculated the static stress change due to the earthquake on hypothetical faults under these volcanoes with Coulomb 3.3. For the dynamic stress change, we computed synthetic seismograms to simulate the waveforms at these volcanoes. We then calculated the Peak Dynamic Stress (PDS) from the modeled peak ground velocities. The resulting values are from moderate to minor changes in stress (10-1-10-2 MPa) with the PDS values generally an order of magnitude larger than the static stress change. Although these values are small, they may be enough to trigger a response by the volcanoes, and are on the order of stress changes implicated in many other studies of volcano and earthquake triggering by large earthquakes. This study provides insight into the poorly-constrained mechanism for remote triggering.